Can we bill for an angiogram and catheter placement for a failed access site done during a Left Heart Catheterization (LHC)? For example, the right radial artery (RRA) access was obtained but we could not navigate the wire to the right subclavian. Right brachial artery angiography was performed through the diagnostic catheter. There was moderate tortuosity and the vessel size was small, and a decision was made to pursue a right femoral artery access. Could we bill 36140-59 and 75710-59 with LHC 93458?
Yes, it is appropriate to bill 36140-59 and 75710-59 along with the appropriate heart cath/coronary angiogram code(s) for what was finally performed. If the doctor did not do a brachial artery angiogram, just removed the catheter after not being able to get through, you would report 36140—59 only.